Tan P C, Hsu J C, Chung H S, Chen Y C, Chang C N
Department of Anesthesiology, Chang-Gung Medical College, Chang-Gung Memorial Hospital, Taipei, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1991 Nov;48(5):333-8.
In 1976, Jannetta et al, suggested that microvascular compression caused by arteries and veins crossing the root entry zone of the facial nerve, was the major etiology of hemifacial spasm (HFS). Surgical treatment has become a major trend. Microvascular decompression (MVD) with teflon patches has a high cure rate. However, the possible occurrence of multiple vessel compression makes it difficult to decide which of these vessels are responsible for the symptom during operation. Recently, a method of abnormal EMG was elaborated upon by Møller and Jannetta in 1987, to ensure the quality of MVD intraoperatively. In this study, we report 6 cases who underwent the procedure successfully. After general anesthesia and muscle relaxation, the abnormal EMG was not suppressed. When the offending vessel was lifted up from the facial nerve, the abnormal EMG disappeared immediately. In each case, postoperative improvement of facial spasm correlated with intraoperative abnormal EMG changes. This method is not only able to guide the surgeon to the vessel that induces HFS but also guarantees the quality of MVD.
1976年，詹内塔等人提出，穿过面神经根部入口区的动脉和静脉所引起的微血管压迫是面肌痉挛（HFS）的主要病因。外科治疗已成为主要趋势。使用聚四氟乙烯贴片的微血管减压术（MVD）治愈率很高。然而，可能出现的多支血管压迫使得在手术过程中难以确定哪些血管是导致症状的原因。最近，莫勒和詹内塔在1987年详细阐述了一种异常肌电图方法，以确保术中MVD的质量。在本研究中，我们报告了6例成功接受该手术的病例。全身麻醉和肌肉松弛后，异常肌电图未被抑制。当致病血管从面神经上抬起时，异常肌电图立即消失。在每例病例中，面部痉挛的术后改善与术中异常肌电图变化相关。该方法不仅能够引导外科医生找到诱发HFS的血管，还能保证MVD的质量。
